Authorization Form

YOU are responsible for all supplemental or additional charges. Any supplements that are left open on your account will be billed to your insurance company. Any billing left open will be billed to owner. A mechanic’s lien will remain in place until the account is paid in full.

* ALL FEES must be paid before vehicle is released.

We make no provisions or concessions for rental cars. Classic will not be responsible for problems that may occur from previous repairs or painting. Classic will not be responsible for fit, finish, and performance of AFTER-MARKET parts, or any NON-FACTORY installed parts, due to inconsistency of quality. The provider of your estimate may require such parts be removed.

Please fill out the form below:

Name

Address

City

State

Phone

Vehicle Year4 digit year

Vehicle Make

Vehicle Model

Mileage

Billing Responsibility

Method of PaymentChoose below for the method of payment for all deductibles and customer paid repairs.

Driver's License NumberEntering in DL# authorizes us to complete the work on your vehicle.

Authorized and Accepted:

You are hereby authorized to make the specific repairs. You or Your Company will not be held responsible for loss or damage to vehicle or articles left in vehicle in case of fire, theft, accident, or any other cause beyond our control. You and your employees may operate the above vehicle for the purposes of testing, inspection, or delivery to me or sublet at my risk.

I authorize any and all supplements to be payable direct to you. I authorize you to act as power of attorney to sign any insurance checks to pay for damages to above vehicle.

Storage will be charged forty-eight hours after the repairs are completed unless prior arrangements have been made. Classic is not responsible for any cars after owner has been notified that the vehicle is ready for pickup. Old parts removed and replaced will be discarded unless otherwise notified before repairs begin.

If you cancel this agreement once parts have been ordered, there will be a 15% restocking fee or full price of parts if special order is non-returnable.